View RCF  - OIRA Conclusion

202108-3137-003CF 202108-3137-002CF
Active 02/28/2022
IMLS
3206-0277 202108-3206-003
Certification of Vaccination Common Form
RCF Recertification
 Approved   08/26/2021
Retrieve Notice of Action (NOA) 08/26/2021
The form will be used by Visitors (i.e. General Public or Federal employees at other agencies) and IMLS contractors. Contractors and Visitors will have to retain (once completed) to show as requested for entry.
None
 
Connie Bodner 202 653-4636 [email protected]

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certification of Vaccination Common Form 100 3 81 Form 3206-0277 Certification of Vaccination Common Form
Form and Instruction OPM 5062 Certification Vaccination Employee
Form and Instruction 3206-0277 Certification Vaccination PRA

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100 100 0 0 0 0
Annual Time Burden (Hours) 3 3 0 0 0 0
Annual Cost Burden (Dollars) 81 81 0 0 0 0

Yes
Miscellaneous Actions
No